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Panic Attack

Medical References

1. Anxiety and Depression Association of America. Panic Disorder. Available at: https://adaa.org/understanding-anxiety/panic-disorder-agoraphobia/symptoms. Accessed 3 May 2019.
2. Mayo Clinic. Panic Attacks and Panic Disorder. Available at: https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021. Accessed 3 May 2019.
3. HelpGuide. Panic Attacks and Panic Disorder. Available at:
https://www.helpguide.org/articles/anxiety/panic-attacks-and-panic-disorders.htm/. Accessed 3 May 2019.
4. Better Health Channel. Panic Attack. Available at: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/panic-attack. Accessed 3 May 2019.
5. Cleveland Clinic. Panic Disorder. Available at: https://my.clevelandclinic.org/health/diseases/4451-panic-disorder. Accessed 3 May 2019.
6. Very Well Mind. Anxiety Attacks vs. Panic Attacks. Available at: https://www.verywellmind.com/anxiety-attacks-versus-panic-attacks-2584396. Accessed 3 May 2019.
7. National Health Service. Are you having panic attacks? Available at: https://www.nhs.uk/conditions/stress-anxiety-depression/understanding-panic-attacks/. Accessed 3 May 2019.
8. National Institute of Mental Health. Panic Disorder: When Fear Overwhelms. Available at: https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms/index.shtml. Accessed 3 May 2019.
9. Very Well Mind. How to Move Past the Stigma of Having Panic Disorder. Available at:
https://www.verywellmind.com/the-panic-disorder-stigma-2584108
10. Johns Hopkins Medicine. Panic Disorder. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/panic-disorder. Accessed 3 May 2019.

Imagine walking down a road, a truck comes out of nowhere and speeds towards you. An immediate and intense feeling of terror takes hold, your heart races and you begin to sweat. Now imagine feeling this way while shopping, driving, watching television, or chatting to a colleague at work.

What is a panic attack?

A panic attack is a sudden overwhelming wave of fear that results in severe physical and emotional reactions. These can range from difficulty breathing or chest pain that feels like a heart attack to feelings of unreality – like you are losing control or going crazy.

Peaking within minutes a panic attack usually lasts between 20 and 30 minutes, rarely more than an hour, and then subsides.1,2,3 

Some people believe that panic attack happens only to those who are hyper-excitable, worry too much or overreact to stress. However, panic attacks are real and frightening, and can happen without warning, even while you are relaxed or asleep. 2

What causes it and who is at risk?

Nervousness and anxiety are normal responses to stress. However, a panic attack occurs, when your flight, fight or freeze response is triggered, often when there is no immediate danger and no obvious cause.2 In this state, your body releases hormones, such as adrenaline, which causes your heart to beat faster and your muscles to tense up.7

Panic attacks are common.4 No one really knows why they occur but the following may play a role:

• Genetics (family history)
• Persistent major stress
• Changes in the way parts of your brain function
• Substance abuse (alcohol and drugs)
• Depression
• Medical conditions (such as asthma, low blood sugar, overactive thyroid gland, heart problems) or medication withdrawal2,3,4,5 

Some people believe that panic attacks happen only to those who are hyper-excitable, worry too much or overreact to stress. However, panic attacks are real and frightening, and can happen without warning, even while you are relaxed or asleep.2

Panic attack and panic disorder

Some people have one or maybe two panic attacks in a lifetime. However, if you have repeated panic attacks and live in a constant state of worry about when your next one will occur, you may have a panic disorder.5,7

That said repeated panic attacks could also be symptomatic of a different condition such as OCD (obsessive compulsive disorder or SAD (social anxiety disorder). For example, someone with OCD might have a panic attack if they are prevented from engaging in ritual or compulsive behaviour. Someone with SAD may have a panic attack before giving a presentation to a group of people at a business meeting.

Panic attack or anxiety attack?

While panic attacks and anxiety attacks may share similar symptoms, a panic attack is usually more extreme, unexpected, without a clear trigger, happens suddenly and goes away fairly quickly.6 Anxiety is excessive or prolonged worry about any number of everyday life events. An anxiety attack often occurs in anticipation of a stressful situation, builds up gradually over a period of time and can last days, weeks, or months.6 

Signs and symptoms

While there are often no warning signs of a panic attack – in addition to being frightening and overwhelming – a panic attack usually has some of the following symptoms:

• A pounding or racing heart
• Breathing problems such as shortness of breath or hyperventilation (breathing very   fast)
• Excessive sweating
• Uncontrollable trembling or shaking
• Chest pain or discomfort

• Feeling dizzy and unsteady on your feet
• Nausea and/or stomach ache
• Chills or hot flushes
• Tingling or numbness in your fingers or toes
• Feeling smothered or sensation of choking

• Irrational thinking or an overwhelming feeling of doom, for example, that you are     losing control, going crazy or going to die3,5,6,8

Keep in mind that symptoms of a panic attack may be similar to the symptoms of other disorders or medical conditions. So, always seek medical advice for a proper diagnosis.

Diagnosis and treatment

If you suffer from repeated panic attacks, you may feel concerned that others, even friends and family might make assumptions about you, may treat you differently or tell you are over-sensitive and overreacting.9 As a result, you may be reluctant to talk to anyone and might delay getting help.9

However, frequent and lengthy panic attacks can become extremely disabling, impacting your ability to function properly at home and at work.4 So, the sooner you talk to someone, the sooner you can begin to understand and manage your panic. Panic disorder is a medical condition and it is treatable.

Diagnosis

Your doctor will likely assess how often you have panic attacks, the intensity of your symptoms and how long they last. He or she will also ask about your medical history and might also conduct blood tests, for example to see if there is an underlying medical condition.1,5

Treatment

Everyone who suffers from panic disorder experiences panic attacks differently so it is important to get professional medical help to:

• Understand what is happening to your body when you have a panic attack
• Figuring out the underlying causes
• Determine the best course of treatment for you

While nutrition, exercise and avoiding stimulants such as caffeine and alcohol will certainly help to reduce nervous tension and stress, lifestyle changes will not help you to confront your fears. If you are diagnosed with panic disorder, treatment will likely include medication and therapy.

Educating yourself and others

Find out as much as you can about panic disorder. Try to avoid self-talk that focuses on your symptoms such as ‘stop panicking’, ‘control yourself’ or ‘relax’.4 While frightening, a panic attack is your body’s alarm system being triggered

Explain your condition to family and friends, people with whom you feel safe and secure, who are likely to be understanding and supportive. Remember, you are not neurotic or crazy.

Please note: This is educational information only and should not be used for diagnosis. For more information on panic attacks and panic disorder, consult your healthcare professional.